Get Fsd-f5-14 Rev B Special Diet Requestdocx

Filling out the FSD-F5-14 Rev B Special Diet Request document online is an important process for ensuring that students with dietary needs receive appropriate meals. This guide provides step-by-step instructions on how to accurately complete this form to support individuals in obtaining the necessary dietary adjustments.

Follow the steps to effectively fill out the special diet request form online.

1. Click ‘Get Form’ button to access the document. This action will enable you to open the form in your browser for online completion.
2. Complete items 1-6 in the Parent/Guardian section. Include the student's last name, first name, and date of birth. Then, circle the meals that the student typically eats at school such as breakfast, lunch, or snack, and sign where indicated.
3. In the School Nurse section, complete items 7-11. Fill in the school name, indicate whether the school operates year-round, provide the school nurse's name, and enter their phone number and fax number.
4. For the Physician section, complete items 12-24. Confirm whether the student has a disability, medical condition, or severe food allergy that necessitates a special diet. If yes, describe the condition, list any severe reactions, and identify the major life activity impacted.
5. Specify the diet order and any liquid modifications if applicable. Indicate any required texture modifications as per the child's needs.
6. Gather necessary signatures from the physician, and ensure that all required details, including the physician's printed name and contact information, are filled out correctly.
7. Finally, review all entries for accuracy. After ensuring everything is correct, you can save your changes, download, print, or share the completed form as needed.

Start completing your special diet request document online today for timely dietary accommodations.